Health Cost Management
Control of health care costs & quality in medicine. Health plan ratings. Accreditation lists/report cards. Benchmark medical fees - average cost by DRG/ICD-9 code. Practice management resources. Cost, quality & liability issues.
Managed care requirements in Medicare and Medicaid. Checkpoint comparisons of managed care health plans. American Association of Health Plans. Integrated Healthcare Association - California. What health plans should know about Clinical Practice Guidelines.
Managed care coursework. Seminars, conferences, symposiums and training sessions on managed care topics.
Headline news on managed care. Managed care glossary. Managed care contracting. International Journal for Quality in Health Care. Cost and quality issues. State regulation of managed care. Newsletters. Statistics. Tutorials. Fact sheets. TQM in health care.
Joint Council for the Accreditation of Hospitals Organizations. American Accreditation HealthCare Commission. Community Health Accreditation Program. Joint Commission International Accreditation. NCQA.
Calculators, manuals related to DRG, APG & ICD-9-CM and ICD-10-CM coding. Index of diagnosis related groups. International classification of diseases ICD-9 code query system.
Average cost by DRG for medical care. Trends in length of stay, charges and functional outcomes in rehab. Benchmark medical fees. Predictors & descriptors of psychiatric duration, costs and service use. Medical Expenditure Panel Survey (MEPS) health care expenditures data.
Medical outcomes assessment and research studies. Medical quality measurements. Physical medicine utilization review.
JCAHO performance measurement ratings for healthcare facilities. HEDIS Report Cards. USQA Quality Reports. NCQA Accreditation. CVO certification. Health plan ranking reports.
Managed Care and Long-term Services for People with Mental Retardation, Health Policy Report: Managed Care and Mental Health, Parity, Issues in Utilization Management.
JCAHO performance measures. ADA/NCQA diabetes measures. AHCPR's CONQUEST. HEDIS. Health care quality improvement. American Academy of Family Physicians Performance Criteria.
Online tutorials for healthcare professionals on how to manage managed care. Examples: Guidance on how a physician can avoid being deselected from health plans. Physician profiling and how it can affect a physician's practice. Expediting MCO Payments. Understanding capitation contracts and stop loss. Full text of the fill-in-the-blanks AMA Model Managed Care Medical Services Agreement. Sample managed care contract. Capitation contracts.
Activities to control disability costs. Guides to work-relatedness of occupational diseases. IME. How WC settlements are viewed in each state and the various forms of settlements. Cost and reserving guidelines for quadriplegia, massive injury, traumatic brain injury.
State programs offering WC discounts for establishing drug-fee programs
Challenging hospital and doctor costs. Entire text of the results of California's survey of workers compensation managed care practices.
Full text of return to work (RTW) programs for the USA federal government, a university and the state of Georgia. Steps to take to establish a return to work program. Forces that adversely affect RTW.